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Healthcare Issues Took a Backseat in Midterms But Abortion Access Figured Prominently in Key States


Abortion access was a key issue in Pennsylvania and other battleground states. The Affordable Care Act receded into the political background, although voters in South Dakota approved a ballot measure that expanded Medicaid, leaving just 11 states that haven't done so.

Healthcare was not a major issue in the midterm elections, but access to abortion was and it appears to have been a decisive factor in several states in the closely contested election.

Voters in California, Michigan and Vermont passed reproductive freedom measures guaranteeing access to abortion yesterday while votes in Kentucky rejected the “No Right to Abortion in Constitution Amendment.”

According to polling done jointly the Kaiser Family Foundation and the Associated Press, 48% of voters in Pennsylvania said the overturning of the Roe v. Wade had a major impact on which candidates they supported in the election. The proportion was similar in other battleground states, including Georgia, Arizona and Nevada.

However, at the national level, only 9% of voters ranked abortion as the most important issue compared with 47% who ranked the economy as most important. Abortion also ranked behind immigration, which 9% of voters ranked as the most important issue.

In hotly contested Pennsylvania, John Fetterman, the Democrat and a supporter of abortion rights, defeated Mehmet Oz, the Republican who tried to stake out a middle-ground position on abortion. In the state’s gubernatorial election, Josh Shapiro, the Democrat, defeated Douglas Mastriano, the Republican, by a wide margin. Shapiro’s campaign emphasized abortion access. Mastriano is strongly opposed to abortion.

As of this 10:30 a.m. Eastern Time this morning, the U.S. Senate races in Georgia, Arizona and Nevada hadn’t been called, although the Democratic candidate in Arizona, incumbent Mark Kelly, was ahead by several percentage points and the incumbent in Georgia, Raphael Warnock, had a slight lead over Republican challenger Herschel Walker. In Nevada, the Republican, Adam Laxalt, had a lead of several percentage points over the incumbent Democrat, Catherine Cortez Masto.

The Affordable Care Act (ACA), which Republicans had vowed to “repeal and replace” and Medicare for All, which Vermont Sen. Bernie Sanders and other progressives have pushed for, did not figure prominently in the campaigns leading up to voting yesterday.

South Dakota was, though, an exception. Amendment D, which expanded Medicaid eligibility, was on the ballot. It passed by a comfortable, 56%- 44% margin. The success of that ballot measure means that there are now just 11 states that have not expanded Medicaid under the ACA.

Related: Medicaid Expansion Is on the Ballot in South Dakota

Other healthcare-related on ballots yesterday included Proposition 209 in Arizona, which adds protections against medical debt collection, and Legislative Referendum 131 in Montana, which classifies an embryo or fetus as a legal person with a right to medical care if it survives an abortion or delivery.

Arizona Voters approved the medical debt proposition by a wide margin. The secretary of state’s office showed it passing, 72% -28%, this morning.

Several news outlets were reporting this morning that with most of the votes counted, Montana voters had rejected the born-alive referendum by 52%-48% margin.

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